Immunologic test to determine if lupus nephritis is present
If a person with lupus has hematuria or proteinuria, what immunologic serology should be done to determine if lupus nephritis is present or active?
The only definitive way to determine if lupus nephritis is present or active is to perform a kidney biopsy.
However, certain types of immunologic serology are useful to establish parameters of activity that can be helpful to diagnose SLE and/or monitor relapses or response to treatment.
Serologic evaluation should include
- • ANA
- • anti-Smith (anti-Sm)
- • anti-Sjögren Syndrome A antigen (anti-Ro/SSA)
- • anti-Sjögren Syndrome B antigen (anti-La/SSB)
- • antiribonucleoprotein
- • anti-dsDNA
- • Complement components
- • Rheumatoid factor
- • Antiphospholipid antibodies
This serology may be positive in a variety of diseases other than SLE, but anti-Sm is quite specific for SLE.
Anti-dsDNA antibodies, when present, are strongly associated with lupus nephritis. Hypocomplementemia and anti-dsDNA antibodies will typically correlate with disease activity.
